Adlerian Psychology / Psychotherapy

Adlerian psychology/psychotherapy was developed by Alfred Adler (1870-1937). Alfred Adler, a historically
influential psychiatrist, began focusing the philosophical world’s attention on relatively new ideas in the early 20th
century. He believed that it was imperative to become intimately familiar with a person’s social context by exploring
factors such as birth order, lifestyle, and parental education. Adler was under the firm belief that each person strives
to belong and feel significant. Adler was a pioneer in the area of holistic theory on personality, psychotherapy, and
psychopathology and believed that a person will be more responsive and cooperative when he or she is encouraged
and harbors feeling of adequacy and respect. Conversely, when a person is thwarted and discouraged, he or she will
display counter-productive behaviors that present competition, defeat, and withdrawal. When methods of expression
are found for the positive influences of encouragement, one’s feelings of fulfillment and optimism increase. Adler
believed strongly that “a misbehaving child is a discouraged child,” and that children’s behavior patterns will improve
most significantly when they are filled with feelings of acceptance, significance, and respect.

Adlerian Psychotherapy
Adlerian psychology places its emphasis on a person’s ability to adapt to feelings of inadequacy and inferiority
relative to others. These emotions may be a result of birth order, especially if the person experienced personal
devaluation at an early age. Or they may be due to the presence of a physical limitation or lack of social empathy for
other people. This method of therapy pays particular attention to behavior patterns and belief systems that were
developed in childhood. Clinicians who use this form of therapy strongly believe that these strategies are the
precursors for later self-awareness and behaviors and are directly responsible for how a person perceives themself
and others in their life. By examining these early habitual patterns, we can better develop the tools needed to create
our own sense of self-worth, meaning and ultimately create change that results in healing.

Adlerian Individual Therapy, Couples Therapy and Family Therapy

Adlerian individual psychotherapy, brief therapy, couple therapy, and family therapy all guide clients to release their
unproductive feelings and to refocus their attention toward forming corrections in perceived values, feelings, and
behaviors that prohibit further positive growth. The Adlerian technique uses Socratic dialogue to inspire the
development of productive and beneficial attitudes in the areas of confidence, self-worth, and significance that result
in a client’s increased ability to naturally cooperate and form cohesive relationships. The paramount goal of this type
of therapy is to remove destructive self-directed beliefs and behaviors and to replace them with tools that will allow a
client to become confident and socially empowered.

Values Clarification and Adlerian Psychology

Individuals often enter therapy to gain better insight into their own behaviors and responses to circumstances that
occur in their lives. Adlerian psychotherapy uses a process of Adlerian values clarification, through which a client is
introduced to their own life organization, including birth order, social context, and other external dynamics, including
parental influences. By understanding this organization, and how it has influenced self-worth, acceptance and
expectations, a client can begin to accept the emotions they have relative to the events they experienced as a child.
This process of perception allows a client to identify, maybe for the first time, with their true inner value,
independent of others. Adlerian values clarification allows one to look at prior beliefs in a new way that encourages
positive change.

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Doing what matters is all about values clarification, knowing what matters to you personally, and taking effective
action guided by those values. Various exercises are employed to help identify chosen values, which act like a
compass from which to direct intentional and effective behavior. People who are fused with their thoughts and tend
to struggle with or avoid painful emotions, often struggle with choosing purposeful and values-guided action.
Through mindful liberation from such struggle they find acting congruently with their values quite natural and
fulfilling.

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Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a form of therapy in which the client and therapist form a trusted
relationship in order to address and dissect issues causing the client distress. Both therapist and client work together
to discover the most pervasive issue and begin addressing that issue first. Because of this, the client develops a
respect for the ability of the therapist and trust begins to grow. The client forms a bond with the therapist by
acknowledging that his or her primary concern has received attention. Cognitive behavioral therapy uses a practical
approach in which the therapist helps the client understand the relationship between beliefs, feelings, and thoughts
and the effect these have on behavior patterns and actions. The client learns that his or her perception will directly
affect his or her reaction to certain conditions and circumstance and that this thought process is at the root of his or
her behavior. Cognitive behavioral therapy was developed by Albert Ellis, Aaron Beck, Maxie Maultsby, Michael
Mahoney, Donald Meichenbaum, David Burns, Michael Mahoney, Marsha Linehan, Arthur Freeman, and others.

CBT Tools and Approaches

CBT encompasses many different therapeutic approaches that have combined to create a fluid and flexible technique.
Therapists will often use several various treatment tools, such as journaling, challenging beliefs, mindfulness, and
relaxation. They will encourage the client to recognize unrealistic perceptions and maladaptive behavior patterns.
Most people who receive this type of therapy usually do so for several months in sessions that last an hour at a time.

Process of Transformation in Cognitive Behavioral Therapy

The process of transformation is rarely fully recognized immediately. Clients learn how to replace negative thoughts
and destructive behaviors with beneficial images, beliefs, and actions that will facilitate recovery. Clinicians often use
CBT for the treatment of many mood disorders in conjunction with mood stabilizing medications. The relationship
between the client and the therapist must be one of complete honesty and trust in order for the client to be receptive
and willing to commit to the changes.

Autism/Asperger's Cognitive Behavioral Therapy

Cognitive behavioral therapy is a widely used form of treatment for many psychological issues. Clients with autism or
Asperger’s syndrome can also benefit greatly from the techniques used in CBT, such as play therapy or music
therapy. Allowing a client to use various forms of expression offers these unique individuals ample opportunity to
communicate their emotions. Many people with autism and Asperger’s also experience mood problems, and through
CBT, can learn strategies for managing their symptoms in order to function more productively. CBT is founded on the
premise that our cognition, how we think of something, affects how we feel and how we act. Thus, CBT address the
cognitive, emotional and behavioral aspects of a client.

For people with autism or Asperger’s, extreme and erratic behaviors can be explored with CBT. Identifying the
cognitive root of the emotion allows a client to understand why they engage in a particular behavior. In CBT, clients
are guided through their emotions using various tools. Some therapists employ relaxation techniques, and others
utilize social, physical and thinking exercises as a method for helping the client gain awareness into their emotional
and behavioral patterns. Books and scrapbooks have proven to be highly effective tools for people with autism and
Asperger’s. By recording emotions and feelings, a client can gain new perspective and begin to develop healthier
responses. Uncomfortable and distracting sounds, textures and scents can be addressed through CBT as well, and
working together, a client and therapist can reconstruct distorted beliefs related to previously disturbing sensations,
and transform them into healthier, more realistic perceptions.

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Red Flags and Concerns in CBT
"There are a few red flags to watch for when working with a cognitive behavioral therapist, and for that matter, any
therapist: One, that the therapist takes the role of the authority on you and your inner world of feelings. You are the
expert and a good cognitive behavioral therapist should respect that. Two, watch for leading questions. Three, be
wary of the controlling and overly directive cognitive behavioral therapist. Three, and perhaps most important to
watch for, is a superficial consideration of your thoughts and feelings. A good cognitive behavioral therapist will
explore the depths and source of the thoughts and feelings you carry. A less experienced cognitive behavioral
therapist will not explore the belief to its fullest and may tend to believe that opposing the belief with positive
thinking or affirmation is enough to counter, compensate, or overcome a belief. A good therapist will take as much
time as is needed to truly, deeply, and respectfully understand and appreciate the source of a belief. It is through
this understanding, not through countering, that healing happens in any therapy, including good cognitive behavioral
therapy." - Excerpt from anonymous email sent to GoodTherapy.org

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Emotionally Focused Therapy
EMOTIONALLY FOCUSED THERAPY (EFT) was developed primarily by Dr. Susan Johnson. Originally developed
for couples, EFT has found effectiveness between family members as well as romantic couples. As its name implies,
emotionally focused therapy is based on emotions. It helps in treating depression, distressed relationships, and much
more. It is currently used in private practices, hospital clinics, and training centers throughout the world. Dr. Susan
Johnson, with other colleagues of EFT, founded The International Centre for Excellence in Emotionally Focused
Therapy (ICEEFT) in 1998. The Centre provides therapist education training including workshops, DVDs, audiotapes,
and externships, as well EFT certification for trainers, therapists, and supervisors. The Centre also facilitates clinical
research studies.

Goals of Emotionally Focused Therapy

EFT's main goals are to expand and reorganize important emotional responses, implement and foster the creation of
a secure bond between partners, and help shift each partner’s position of interaction while initiating new cycles of
interaction that are more beneficial for the relationship. Emotionally focused therapy helps create secure and lasting
bonds between partners and family members and strives to reinforce the positive bonds that already exist. EFT is a
practical technique that has enormous success with couples, and can facilitate change in marriages and relationships
that exhibit a wide range of challenges. EFT works to intervene where needed and create change to help
relationships work more effectively through a spirit of harmony and respect.

Emotionally Focused Therapy for Couples

Emotionally focused therapy is generally a short-term (8-20 sessions) couples therapy approach, though it is also
used with families. It has been found that 70 to 75 percent of couples effectively move from distress to recovery
using EFT and approximately 90 percent of couples show significant improvement in their relationships. EFT has a
basis in clear and explicit conceptualizations of adult love and marital/relational distress. It is a collaborative approach
that respects clients and helps them implement new strategies called “change strategies” and interventions.

Techniques of Emotionally Focused Therapy

Through the exploration of emotions, reactions, inter-relations, and behaviors, couples can identify and study their
individual roles and the effect each has on the dynamic of the relationship. Each participant is encouraged to express
their experiences and emotions in a non-judgmental and secure environment. By witnessing the release of feelings
and anxieties of one partner, the other is able to gain new insight and perception into the validity and emotional
state that their own actions and experiences have on the relationship as a whole. Without criticism or consequences,
the partners are permitted to voice their deepest concerns and conflicts in order to address them and move beyond
to develop more productive and collaborative behaviors.

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Dialectical Behavior Therapy
Marsha M. Linehan, developer of dialectical behavior therapy (DBT), originally set out to address the needs of
women with histories of suicidal ideation, suicide attempts, or tendencies to self-harm through her training as a
behaviorist. However, she discovered that in reality she was treating people who were symptomatic of Borderline
Personality (BPD). Dialectical behavior therapy (DBT) is founded on the belief that environmental and biological
factors that remain undetermined cause some people to respond to emotional states more quickly, and sustain a
heightened emotional affect for an extended period of time before they return to baseline. This discovery gives
credence to the symptoms of BPD which include lives fraught with crisis and severely shifting emotional peaks and
valleys. DBT helps these people learn coping techniques that they did not receive in their invalidated childhoods.

Five Core Criterion of Dialectical Behavior Therapy

According to Linehan, the core criterion that must be met for comprehensive psychotherapy to be valid encompasses
five factors. It is essential that the therapy:

1. Expands and sustains the motivation the client possess to facilitate transformation
2. Provides opportunity for the client’s skills to be further developed
3. Assimilates the client’s new skill set to be applicable in multiple relevant situations and circumstances
4. Develops the therapist’s own abilities while increasing the therapist’s desire to effectively and willingly treat
people
5. Provides a nonjudgmental and secure environment in which the healing process can occur

Team Structure of Dialectical Behavior Therapy

Skills are learned and developed through an integrated system of group therapy, phone contact, in vivo coaching,
and additional at home tasks. In order to maintain the enthusiasm and focus of the therapist, regular consultations
are required for teams of clinicians. The team structure provides feedback to the therapist and gives a foundation of
support to ensure the therapist maintains the most beneficial course of action. In fact, the criteria for this treatment
is not met unless a weekly DBT meeting is held. Lastly, the therapy structure can be designed to be inclusive of
family members as a method of measuring progress and responses in the home environment.

DBT Stages and Goals

DBT utilizes a system of stages and target goals to ensure that it does not fall victim to treating present issues only.
In addition, DBT uses a progression system that focuses on the most prevalent issues first, such as injurious or
harmful conditions, and then reverts to the less pressing issues in order of relevancy to the continuation of
treatment. Behavior patterns that negatively impact the client’s life, development of coping skills and other
extenuating issues are addressed once the primary risk factors have been worked on. Ultimately, the therapist
focuses first on sustaining life, secondly on sustaining therapy, and thirdly on providing the resources and tools to
effect a positive change in the client’s life.

Resources Related to Dialectical Behavior Therapy:

There is a DBT skills discussion list at University of Washington. To subscribe, send mail to the listowner (Kieu) at
busserv@u.washington.edu explaining your background and why you'd like to be on the list. It's intended to be a
place to share experiences and get support while using DBT skills.

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Family Systems Therapy
Family systems therapy draws on systems thinking to view the family as an emotional unit. When applied to families,
systems thinking—evaluating the parts of a system in relation to the whole—suggests that an individual’s behavior is
informed by and inseparable from the functioning of his or her family of origin.

The Development of Family Systems Therapy

Family systems therapy is based on Murray Bowen’s family systems theory, which holds that individuals are
inseparable from their network of relationships. Like other psychoanalysts of his time, Murray Bowen was interested
in creating more scientific and objective treatment processes as an alternative to conventional diagnostic frameworks
and pathological language. Bowen believed that all therapists experienced challenges within their family of origin and
that this awareness could help therapists normalize human behavior for their clients. Bowen introduced family
systems theory in the late 1960s after years of research into the family patterns of schizophrenic patients and the
patterns of his own family of origin.

Whereas traditional individual therapy addresses the individual’s inner psyche in order to effect change in his or her
relationships, Bowen’s theory suggests addressing the structure and behavior of the broader relationship system that
informs the character of the individual. Bowen also claimed that the change in behavior of one family member
would necessarily influence the way that the family functions over time.

Family Systems Therapy Approaches

Many forms of family therapy are based on family systems theory. Family systems approaches generally fall under
the categories of structural, strategic, and intergenerational:

 Structural family therapy looks at family relationships, behaviors, and patterns as they are exhibited
within the therapy session in order to evaluate the structure of the family. Therapists also examine
subsystems within the family structure, such as parental or sibling subsystems. Structural family therapy
was designed by Salvador Minuchin, who would employ activities like role-playing in a therapy session.
 Strategic family therapy examines family processes and functions, such as communication or problem-
solving patterns, by evaluating family behavior outside the therapy session. Therapeutic techniques may
include reframing or redefining a problem scenario or using paradoxical interventions—those that suggest
the family take action that appears to be in opposition to their therapeutic goals in order to create the
desired change. Strategic family therapists believe that change can occur rapidly, without intensive analysis
of the source of the problem. Prominent psychotherapists such as Jay Haley, Milton Erickson, and Cloe
Madanes helped develop strategic family therapy.
 Intergenerational family therapy acknowledges generational influences on family and individual
behavior. Identifying multigenerational behavioral patterns, such as managing anxiety, can help people see
that their current problems may be rooted in previous generations. Murray Bowen designed this approach to
family therapy, and he used it in treatment for individuals and couples, as well as families. Bowen employed
techniques such as normalizing a family’s problems by discussing similar scenarios in other families;
describing the reactions of individual family members, as opposed to acting them out; and encouraging
clients to respond with “I” statements, rather than blaming statements

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Feedback Informed Treatment
FEEDBACK INFORMED TREATMENT (FIT) was co-developed by Scott Miller and Barry Duncan. This innovative
and simple technique involves posing a series of questions to a client, both before and after a therapy session. The
emphasis of this therapy is not on the talk therapy processes, but rather the alliance formed between the therapist
and client and the client’s evaluation of the experience as a compass for further treatment techniques. "Client
directed" therapy started with Barry Duncan's 1992 book, Changing the Rules: A Client Directed Approach, which was
influenced by Michael Lambert's rendition of the common factors in John Norcross' 1986 Handbook of Psychotherapy
Integration. Changing the Rules attempted to operationalize the common factors commensurate to their relative
impact on outcome. "Client directed" spoke to the influence of clients on outcome: their resources, strengths, and
resiliencies, their view of the alliance, their ideas and theories of how they can be helped, and their hopes and
expectations. The common factors, in other words, make the case that clients should direct the therapeutic process—
their views should be the privileged ones in the room. "Client directed" became "client directed, outcome informed"
in 2000 with the publication of Barry Duncan and Scott Miller's book, Heroic Client. Shortly thereafter the Outcome
Rating Scale (ORS) and the Session Rating Scale (SRS) were developed to be used in clinical practice.

First Formal Scale of FIT: Outcome Rating Scale

The first formal scale, called the Outcome Rating Scale (ORS), is administered to the client at the beginning of a
therapy session. This tool is composed of four short questions and is used to gauge the progress a client has made
since his or her last session. Vital information is gathered from the client and this information is extremely useful to
the therapist in determining if any external influences or environmental situations have delayed or enhanced the
client’s progress.

Second Formal Scale of FIT: Session Rating Scale

The second formal scale, called the Session Rating Scale (SRS), is a four-question assessment administered at the
conclusion of a session and used to assess the client’s overall therapy experience. This form of assessment has
proven to be a very effective system for determining the progress of a client. In addition, the SRS allows the
therapist to evaluate the current approach being used and decide if a change of course would better assist the client
in achieving a positive outcome. This immediate feedback serves both the client and therapist in streamlining and
focusing the therapy in such a way as to facilitate the desired results as quickly as the therapy will allow.

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Gestalt Therapy
Gestalt therapy, developed by Fritz Perls, Laura Perls, and Paul Goodman in the 1940s, is an experiential and
humanistic form of therapy that was originally designed as an alternative to conventional psychoanalysis. Gestalt
therapists and their clients use creative and experiential techniques to enhance awareness, freedom, and self-
direction. The word gestalt comes from the German word meaning shape or form, and it references the character or
essence of something.

Principles of Gestalt Therapy

At the core of gestalt therapy is the holistic view that people are intricately linked to and influenced by their
environments and that all people strive toward growth and balance. Gestalt therapy is similar to person-centered
therapy in this way, as well as in its emphasis on the therapist’s use of empathy, understanding, and unconditional
acceptance of the client to enhance therapeutic outcomes.

According to gestalt therapy, context affects experience, and a person cannot be fully understood without
understanding his or her context. With this in mind, gestalt psychotherapy recognizes that no one can be purely
objective—including therapists whose experiences and perspectives are also influenced by their own contexts—and
practitioners accept the validity and truth of their clients’ experiences.

Gestalt therapy also recognizes that forcing a person to change paradoxically results in further distress and
fragmentation. Rather, change results from acceptance of what is. Thus, therapy sessions focus on helping clients
learn to become more self-aware and to accept and trust in their feelings and experiences to alleviate distress.

Gestalt therapy places emphasis on gaining awareness of the present moment and the present context. Through
therapy, clients learn to discover feelings that may have been suppressed or masked by other feelings and to accept
and trust their emotions. Needs and emotions that were previously suppressed or unacknowledged are likely to
surface as well. Through this process, a person gains a new sense of self as overall awareness increases.

The focus on the here and now does not negate or reduce past events or future possibilities; in fact, the past is
intricately linked to one’s present experience. The idea is to avoid dwelling on the past or anxiously anticipating the
future. Experiences of the past may be addressed in therapy sessions, but the therapist and client will focus on
exploring what factors made a particular memory come up in this moment, or how the present moment is impacted
by experiences of the past.

Working with a Gestalt Therapist

Gestalt therapy sessions do not follow specific guidelines, in fact, therapists are encouraged to use creativity in their
approach with clients, depending on context and the personality of the current client. What is consistent is the
emphasis on direct contact between therapist and client, direct experience and experimentation, and the focus on
the “what and how”—what the client is doing and how he or she is doing it—and the “here and now.”

Together, therapist and client will evaluate what is happening now and what is needed as a result. Therapists refrain
from interpreting events, focusing only on the immediate, including the physical responses of the client. Remarking
on subtle shifts in posture, for example, can bring the client into the present. In this way, gestalt therapy helps
clients gain a better understanding of how their emotional and physical bodies are connected. Understanding the

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internal self is the key to understanding actions, reactions, and behaviors. Gestalt therapy helps a client take the first
step into this awareness so that they can acknowledge and accept these patterns.

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Gottman Method
The Gottman Method was developed by Drs. John and Julie Schwartz Gottman. The Gottman Method is based on the
principals taught in The Gottman Institute. This facility works to administer healing to couples and provides in-depth
training and knowledge to health care providers and mental health professionals alike. The Gottman Institute relies
on long-term scientific research on the success or failure of marriages to deliver intense therapy to couples in need.
Their mission is to recognize that there are families in crisis situations and each member of a family is uniquely
deserving of and capable of compassion. The Gottman Institute strives to assist families in forming better
relationships in love and health and to develop further understanding of intervention processes that can successfully
be implemented. The Gottman Institute aims to be accessible across all economic, racial, and cultural sectors and is
keenly aware of the well-being of their own staff as they understand that compassion and healing begins at home.

Gottman Method Couples Therapy

The Gottman Method Couples Therapy is a scientifically based form of therapy that is delivered in a structured
manner so as to attain goals outlined in the therapeutic environment. It strives to assist clients in achieving a deeper
sense of understanding, awareness, empathy, and connectedness within their relationships that ultimately leads to
heightened intimacy and interpersonal growth. By combining therapeutic interventions with scientifically founded
couples exercises, the therapy helps clients develop the tools necessary to remove the natural walls and defenses
that hinder and prohibit effective communication and bonding. After years of research, this remarkably effective form
of treatment has been proven to provide positive results that facilitate the development of permanent changes within
the dynamic of the couple relationship.

Goals and Principles of the Gottman Method

The principle goals of the Gottman Method Couples Therapy are to disarm conflicting verbal communication, to
increase intimacy, respect, and affection, to remove barriers that create a feeling of stagnancy in conflicting
situations, and to create a heightened sense of empathy and understanding within the context of the relationship.

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Mindfulness Based Approaches
Mindfulness Based Approaches are designed to deliberately focus one’s attention on the present experience in a way
that is non-judgmental. Mindfulness has its roots in Eastern techniques, in particular Buddhist
meditation. Mindfulness Based/Contemplative Based Approaches were developed by Zindel Segal, Jon Kabat-
Zinn, Mark Williams and John Teasdale. The practice requires that one intentionally directs focus away from states of
mind that would otherwise occupy them, such as frightening or worrisome thoughts, and instead observe and accept
the present situation and all it has to offer, regardless of whether that is good or bad. Mindfulness approaches
include mindfulness based cognitive therapy, (MBCT), mindfulness-based stress reductions (MBSR), acceptance and
commitment therapy (ACT) and dialectical behavior therapy (DBT). Mindfulness based approaches and contemplative
approaches are becoming widely accepted methods for relieving symptoms related to many psychological issues and
can be applied across many different population segments. Mindfulness is practiced individually or in group settings.

Healing Process with Mindfulness Based Approaches

Mindfulness based approaches can be molded to address a multitude of symptoms and circumstances. Clients
progress to mindfulness over time, and it requires dedication and practice. Once the skill of mindfulness has been
learned, a client is able to integrate this therapeutic technique into virtually any situation that presents itself in order
to maintain a sense of control in what might otherwise be an overwhelming experience. Psychological insight and
emotional healing occur over time through the regular practice of mindfulness.

Mindfulness Meditation
Mindfulness based approaches are most commonly delivered through mindfulness meditation. The clinician instructs
the client to direct their focus to the present moment. If the client becomes aware that their thoughts wander away
from the present, they are taught to take note of their thoughts, of where they are and what they are about, with
non-judgmental and open awareness, and bring their attention back to the present moment. The clinician works with
the client to help them recognize what emotions and feelings these meandering thoughts created, and also to be
aware of any physical sensations or urges associated with these thoughts.

Issues Mindfulness Based Approaches Can Help With

Mindfulness based approaches and contemplative approaches are aimed at relieving the symptoms of psychological
stress, negative mental states and physical pain. One technique of mindfulness involves using gentle yoga
movements and meditation to heighten a client’s awareness of physical sensations. The client is guided through
verbal cues to maintain attention on movement, breathing and feelings throughout several different exercises.
Walking and sitting meditations are common tools for the mindfulness based approach. Eventually, the client is
encouraged to practice mindfulness in daily life. This continues the therapeutic process outside of the confines of the
client-therapist session and allows the client the opportunity to observe, explore and experience mindfulness in a
non-clinical environment. The clinician and client evaluate and examine the effects and obstacles encountered during
daily life, and use this as a catalyst for behavior and thought modification.

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Motivational Interviewing
MI focuses on re-patterning client behavior that is the result of ambiguous and undefined thoughts. This form of
therapy is presented in a direct and client targeted manner that strives to transform undesired behaviors.

Goal of MI
The goal of MI is to aid the client in clarifying his or her own perceptions and beliefs in order to direct him or her in a
more decisive way. Most people who respond to this type of treatment have struggled for years in a mire of
ambivalence and welcome the opportunity to have vision and focus in their lives.

MI and Addiction
MI is commonly used for the treatment of addictions, including abuse of alcohol and other substances. MI is
administered in a receptive atmosphere that allows a client to receive feedback from the therapist for the purpose of
fortifying the client’s resolve for transformation and to empower the client with a feeling of self-control. Rather than
engaging the client’s defense mechanisms through confrontational discourse, the therapist works with the client to
create positive affirmations and a sense of inner willingness to facilitate change. Once that is achieved, the client
becomes receptive to the healing process and progresses toward wellness.

Clients who are faced with the challenge of substance abuse experience similar emotional and mental symptoms to
rebellious adolescents, including resistance, narcissism, relational difficulties, and moodiness. MI has been proven to
provide substantial relief from these symptoms and has been recognized as a useful tool for gaining control of these
unwanted behavior patterns. MI can be applied to clients regardless of their commitment level and the course of
treatment is usually brief. It has shown significant efficacy in clients who have previously demonstrated strong
resistance to or weak motivation for change. It is particularly helpful to adolescents dealing with similar issues.

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Narrative Therapy
Narrative therapy was developed by Michael White and David Epston. Narrative therapy is a method of therapy that
separates the person from the problem (externalizing the problem) and encourages people to rely on their own skill
sets to minimize the problems that exist in their everyday lives. Throughout life, personal experiences are
transformed into personal stories that are given meaning and help shape a person’s identity, and narrative therapy
utilizes the power of people’s personal stories to discover the life purpose of the narrator.

Principles of Narrative Therapy

Narrative therapy was created as a non-pathologizing, empowering, and collaborative form of therapy that
recognizes that people possess natural competencies, skills, and expertise that can help guide change in their lives.
People are viewed as separate from their problems, and in this way, a therapist can help externalize sensitive issues.
This objectification dissipates resistance and defenses and allows a client to address this issue in a more productive
manner.

Rather than transforming the person, narrative therapy aims to transform the effects of the problem. The objective is
to get some distance from the issue, and in this way, it is possible to see how a particular concern is serving a
person, rather than harming him or her. For example, posttraumatic stress might help protect a person from the
difficult emotions associated with a particular event, although it also contributes a host of new troubling symptoms,
such as anxiety. This process of externalization can help a person develop greater self-compassion, which, in turn,
can help him or her to feel more capable of change. In fact, some psychologists have identified a process termed
"posttraumatic growth" to account for the positive personal change that can occur to people who have experienced a
traumatic event. Narrative therapists also help clients view their problems within the context of social, political, and
cultural storylines that influence the way we view ourselves and our personal stories.

Narrative therapy can be used for individuals, couples, or families. In a couple or family setting, the technique of
externalizing problems sets the stage for creating positive interactions and transforming negative communication or
responses into more accepting, nonjudgmental, and meaningful exchanges. Seeing a problem objectively helps
couples and families to reconnect with the heart of their relationship and address the ways in which the problem has
challenged that core strength.

Narrative Therapy Techniques

Practitioners of narrative therapy believe that simply telling one’s story of a problem is a form of action toward
change. Narrative therapists help to objectify problems, frame them within a larger sociocultural context, and make
room for other stories. Together, therapist and client identify and build upon “alternative” or “preferred” storylines
that exist beyond the problem story; these provide contrast to the problem, reflect a person’s preferences, and offer
opportunities to rewrite one’s story. In this way, people move from what is known (the problem story) to what is as
of yet unknown.

The therapist also helps people to see what is “absent but implicit” in the presentation of a problem. By exploring the
impact of the problem, it is possible to identify what is truly important and valuable to a person in a broader context,
beyond the problem. This can help a person identify a common thread to connect his or her actions and choices
throughout life. In other words, all the “other” experiences and values from life are “absent but implicit” as people
navigate new terrain. This process can help a person better understand his or her experience of life and gain
personal agency for addressing problem scenarios in the future.

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The principle intervention in narrative therapy is the craft of asking questions to bring forth the preferred story. First,
the problem is named and externalized. Next the therapist inquires about the “effects” of the problem on the person
and their relationships. In investigating the influence of the problem over the person, events or steps that contradict
the problem emerge (exceptions to the problem) referred to as “unique outcomes.” Unique outcomes became an
entry into a new story. The therapist then asks questions to perform new meanings and expand on the unique
outcomes leading to alternative stories. Other practices, such as letter writing, are utilized to document the new
stories that are developing.

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Object Relations Therapy
Object relations is based on the theory that the primary motivational factors in one's life are based on human
relationships, rather than sexual or aggressive triggers. Object relations is a variation of psychoanalytic theory and
diverges from Freud’s belief that we are pleasure seeking beings; instead it suggests that humans seek relationships.
Because relationships are at the center of this method of therapy, the client-therapist allegiance is paramount to the
success of the treatment. This theory was developed by Melanie Klein, William Ronald Fairbairn, Anna Freud, Michael
Balint, and Donald Winnincott.

Object Relations Theory

The object relations theory suggests that during the formation of early relationships, the infant psyche identifies part
objects by the function they serve. For example, a breast that produces milk is seen as a good breast. A hand that
touches and caresses is seen as a good hand. But a mouth that yells and hurts is seen as a bad mouth. These object
identities develop through years of receiving care and the events that occur during that time. Although these
representations are skewed and do not accurately depict the tangible object, they eventually grow to represent them.
This causes extreme ambivalence within a client who has seen good and bad parts of the same person.

Object Relations Therapy: The Mother-Infant Dyad and the Therapy Relationship
This primary center of the theory is a reflection of the mother-infant dyad. Object relations therapy is a marriage of
theories developed by Ronald Fairbairn, Donald Winnicott, and other members of the British Independent group, as
well as the Kleinian theory. Although each has varying components and suggests different underlying structures, the
theories all agree that the mother-infant experience is responsible for the formation of a child’s psychic structure
during the first three years of life. Object relations believes that a person’s mind develops as a direct result of
formidable relationships. The “objects” represent perceptions of real people in a person’s life experience. Because
these relationships are forged in infancy, they continue to pervade a person’s existence throughout his or her life.

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Psychodynamic Therapy
Psychodynamic therapy—the psychological interpretation of mental and emotional processes—is rooted in
traditional psychoanalysis and draws from object relations, ego psychology, and self psychology. Developed as a
simpler, less-lengthy alternative to psychoanalysis, psychodynamic therapy aims to address the foundation and
formation of psychological processes in order to alleviate symptoms and improve people’s lives.

Core Principles of Psychodynamic Therapy

In psychodynamic therapy, therapists help people review emotions, thoughts, early-life experiences, and beliefs to
gain insight into their lives and their present-day problems and to evaluate the patterns they have developed over
time. Recognizing recurring patterns helps people see the ways in which they avoid distress or develop defense
mechanisms as a method of coping so that they can take steps to change those patterns.

The therapeutic relationship is central to psychodynamic therapy as it can demonstrate the manner in which the
client interacts with his or her friends and loved ones. In addition, transference in therapy—the transferring of one’s
feelings for a parent, for example, onto the therapist—can also help illuminate the ways that early-life relationships
affect a person today. This intimate look at interpersonal relationships can help a person to see his or her part in
relationship patterns and empower him or her to transform that dynamic.

Psychodynamic therapy is available to individuals, couples, families, or groups as short-term or long-term therapy.
Brief psychodynamic therapy is goal-oriented and can take as many as 25 sessions, whereas long-term
psychodynamic therapy may take two years or more.

Accessing the Unconscious

In order to keep painful feelings, memories, and experiences in the unconscious, people tend to develop defense
mechanisms, such as denial, repression, rationalization, and others. Psychodynamic therapists encourage clients to
speak freely about their emotions, desires, and fears in order to reveal vulnerable feelings that have been pushed out
of conscious awareness. According to psychodynamic theory, behavior is influenced by unconscious thought, and
once vulnerable or painful feelings are processed the defense mechanisms reduce or resolve.

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Psychoanalysis / Modern Psychoanalysis
Developed by Sigmund Freud, modern psychoanalysis is a dichotomy in psychology as it has been revered and
refuted by the general public throughout the years. The success of this therapy, particularly in European countries,
has served to sever it from its true roots. Psychoanalysis has been used in sociology, religion, literature, and even in
mythology and through these mediums gained momentum and recognition with the general population. However, its
therapeutic and clinical purposes were overshadowed by its cultural acceptance. Seen as one of the most influential
theories in history, psychoanalysis appeared in our culture as a revolutionary and innovative model of construction
that dared to oppose and challenge existing formulations and morals. The debate continues to this day as to whether
this pervading clinical method of therapy has any validity in modern behavioral medicine or if it merely represents a
meandering and colorfully narrative description of Freud’s own distorted perceptions and beliefs.

Principles of Psychoanalysis
Although the field of psychoanalysis encompasses a vast number of therapeutic models, there are three main
principles at its core:

1) Psychoanalysis is the technique of researching and discovering the ways of the mind and the thought processes.
2) Psychoanalysis maintains a specific set of ideas with regard to human behavior.
3) Psychoanalysis is a form of therapy for the treatment of various emotional and psychological disturbances.

Role of Therapist in Psychoanalysis

Every area of psychoanalysis utilizes dreams, fantasies, and associations as well as the expression of thoughts both
verbally and physically. The therapist uses this information to incite the inner battles being waged that are directly
responsible for the appearance of symptoms and behavior problems. These issues can be so overwhelming or
distracting that they cause the person to seek treatment. The therapist works with the client to address the
underlying issues and work through transference and resistance. Ultimately, the client will gain insight into their own
skewed reactions and realize what transformations need to occur with respect to their intrapersonal relations.

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Solution Focused Therapy
Solution focused therapy (SFT) targets the desired outcome of therapy as a solution rather than focusing on the
symptoms or issues that brought someone to therapy. This technique only gives attention to the present and the
future desires of the client, rather than focusing on the past experiences. The therapist encourages the client to
imagine their future as they want it to be and then the therapist and client collaborate on a series of steps to achieve
that goal. This form of therapy involves reviewing and dissecting the client’s vision, and determining what skills,
resources, and abilities the client will develop and use to attain his desired outcome. Solution focused therapy was
developed by Steve De Shazer, Insoo Kim Berg, and their team at the Brief Family Therapy Family Center in
Milwaukee, USA.

How Does Solution Focused Therapy Work?

SFT is a form of talk therapy that maintains that change is inevitable and constant. The therapist who conducts the
SFT will examine the elements of the client’s life that they wish to alter and also those elements that want to leave
unchanged. Working together, the client and therapist devise a vision of what the possible future could look like.
They work to mold and define it as detailed as they can in order to allow the client to hold that clear picture in his or
her mind.

The therapist then guides the client in finding specific moments in his or her life in which he or she felt similar to
what he or she may experience in his potential future image. Correlating the two visions, or experiences, allows the
client to identify which actions they took in the past to achieve a similar outcome to the one they would like to
achieve in the future. Often the client is hindered from making forward progress due to the results that came
following the happy experience. However, the basis of this form of therapy is to maintain a constant focus on the
future, and to only rely on the past experiences as a resource.

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Systems Theory / Therapy
Systems psychology uses complex systems to explore behavior patterns and human experience. This integrated
approach to therapy is based on the techniques of Gregory Bateson, Roger Barker, Ludwig Bertalanffy, Anatol
Rapoport, Kenneth Boulding, William Ashby, and Margaret Mead. This method identifies individuals and groups as
seeking homeostasis. Systems psychology is practiced within the realm of engineering psychology, but focuses on
affective, motivational, cognitive, and group behavioral patterns. In order to facilitate an effective system for all
parties involved, the expectations, needs, desires, and characters of all are examined and considered.

Systems Theory in Therapy

The goal of Systems Therapy is for a group to gain insight into each member’s role as it relates to the healthy
functionality of the whole. Systems Therapy can be applied to organizations, couples, communities, or families. The
technique relies on identifying specific behavior patterns and how each member responds to anxiety within the
dynamic. By doing this, the individual participants can begin to understand and transform their patterns to more
adaptive, productive behaviors.

Systems Therapy has evolved from a rather single dimensional form of treatment to a multi-faceted method that is
applied to many different situations. It strives to help the members of the group attain positive, secure relationships
in order to improve their well-being and inter-relational experiences. Many different conflicting situations and issues
can be effectively treated with Systems Therapy.

This dynamic and widely recognized form of psychotherapy believes that the family or community is a vital
component in its own recovery and to its psychological health. Families, couples, or members of an organization are
directly involved in their own therapy in order to resolve the issue, even if it is one of an individual basis. One of the
tools used in this type of therapy is communication. Dialogue is constructed in such a way as to facilitate the
recognition and development of knowledge, strengths, and support for the entire entity.

Systems Theory and Therapy for Families

Family systems theory was developed by Dr. Murray Bowen as a way to allow each family member to work together
to solve individual issues. Every family member is connected to each other through a system of overlapping and
intertwining relationships that can only be deciphered when all members work as one. In family systems therapy,
participants are prompted to express the roles they portray in their normal family life, but must maintain the
structure of the therapy, respect one another and stay within the predetermined boundaries. During family systems
therapy, family members act out their roles in such a way that the therapist and other family members are able to
see the cause and effect of certain behaviors. Once these are recognized, the members can work to understand how
their actions affect each other’s roles and begin to adopt positive behaviors that benefit themselves and the family as
a whole

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Trauma-Focused Cognitive Behavioral Therapy
Trauma-focused cognitive behavioral therapy (TF-CBT) was developed by Judith Cohen, Anthony Mannarino,
and Esther Deblinger. TF-CBT is designed for youth who have experienced a significantly traumatic event. Trauma-
focused cognitive behavioral therapy is used to help people experiencing clinical posttraumatic stress return to a
healthy state of functioning after a traumatic event. This therapy is used for the parents or caregivers, children, and
adolescents in a way that decreases the negative behavior patterns and emotional responses that occur as a result of
sexual abuse, physical abuse, or other trauma.

How Does Trauma-Focused Cognitive Behavioral Therapy Work?

This form of therapy integrates interventions that are specifically tailored to meet the needs of people experiencing
emotional and psychological difficulties as a result of a trauma and combines them with humanistic, cognitive
behavioral and familial strategies. Through TF-CBT, both parents and children learn how to process their emotions
and thoughts that relate to the traumatic experience. They are given the necessary tools to alleviate overwhelming
thoughts that can cause stress, anxiety and depression and are taught how to manage their emotions in a healthier
way. The goal of TF-CBT is to allow both the child and the parent to continue to develop their skills and
communication techniques in a healthy manner.

Children, Parents, and Trauma-Focused Cognitive Behavioral Therapy

Children, specifically adolescents, who are suffering severe emotional repercussions due to trauma respond
extremely well to this technique. The therapy helps children who have experienced repeated episodes of trauma, as
in abuse or neglect, or those who have suffered one occurrence of sudden trauma in their lives. Children who are
learning to cope with the death of a loved one can also benefit greatly from TF-CBT.

A secure and stable environment is provided that enables the child to disclose the details of the trauma and it is at
this time that the cognitive and learning theories of treatment are applied. The child is shown his distorted
perceptions and is given the tools to redesign those attributes relating to the trauma. Parents, who are not the
abusers, are also given the resources and skills necessary to help their children cope with the psychological
ramifications of the abuse.

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